I got back from our 2 year checkup and my pediatrician seemed nonchalant about her weight remaining the same for the last six months (21.5 pounds) he said I could opt to see a nutritionist now or in three months. (Her height, head and other development milestones are fine.)I said the sooner the better and he said he'd arrange for a referral. So when I contacted his office this morning to get the info (instead of waiting for it in the mail) I found out that she had been diagnosed as "failure to thrive" and the referral was actually to a hospital instead of the outpatient nutritionist.

He has been pressuring me to wean since 18 months due to her low weight and that just seems counter intuitive. My constant argument has been that if she isn't getting enough nutrients then cutting off breastmilk to be replaced with cows milk is just plain stupid. Call me defensive but it just doesn't make sense that it is our nursing that is causing this issue.

I realize I am in the minority here with nursing a 2 year old 5-8 times a day. I do suggest other food that she eats 50 percent of the time but she just wants to nurse. I follow her cues. But now with the referral to the hospital nutritionist I'm concerned that nursing is going to be under attack again. We nurse in the afternoon before bed and a couple times during the night or morning.

For the record she is an incredibly verbal and responsive child. She climbs, runs and plays hard. She mainly eats cereal, whole milk yogurt, whole string cheese, tofu, mac and cheese, noodles and cheese, grean beans, toasted bread, broccoli, bananas, oatmeal with flax seed, raisins, pears, apples, oranges, broiled carrots ... just not a LOT. Actually the only thing she will eat a lot of are these no salt organic corn chips from trader joes. She'll eat those until the cows come home and within the last day or so I've been continuing to give them to her without any restriction. After reading the label they have iron, fat and fiber and no sodium so she can go to town on those if she wants.

So basically I'm wondering if any other ladies had pressure to wean in a toddler due to slow weight gain. My gut is saying to continue nursing as long as she asks for it (I'm fine with it, no problem on my end). I'm wondering if she's got an allergy, intolerance, or possibly celiac but her symptoms are so elusive and inconsistent. I'm sure there is a reason she is nursing so much and I'm relieved we will get help from a nutritionist ... but i need some support because I'm scared the nutritionist is also going to really force the weaning since our extended nursing is exceptional.

Any tips for dealing with the nutritionist? I WANT my daughter to gain weight to be more "normal" but i really don't want to further complicate the problem by eliminating nursing. And I also don't want them to flag my insistence on nursing as a behavioral issue that might be contributing to her lack of desire to eat food.

Your help is appreciated.

Thanks. <3

February 3rd, 2012, 03:59 PM

@llli*mommal

Re: failure to thrive, was told to wean

I am so sorry you're getting pressure on the weaning front! I think that your doc's advice is simply stupid: why replace human milk with cow's milk, when you don't even know if your child will drink enough of it to make a difference? :scratch. I'd see a different pediatrician. My understanding is that FTT is a diagnosis which requires more than low weight. You also have to see failure to grow in height or head circumference, or failure to master milestones at an appropriate pace.

I think that when you go in to speak to the nutritionist, just treat nursing as non-negotiable. If the nutritionist says "wean" you can respond with "I will not do that, so let's focus on things we can do aside from that."

February 3rd, 2012, 04:55 PM

@llli*scienceteachermommy

Re: failure to thrive, was told to wean

Instead of defending your choices, make them defend theirs. Why should you wean? What advantage would that be in her diet? What is better about cow's milk than breast milk?

You could also go in with the attitude that the nutritionist will agree with you. You say, "she still nurses 5-8 times a day, which of course is great for her since it is very healthy for her."

February 3rd, 2012, 05:03 PM

@llli*abaker89

Re: failure to thrive, was told to wean

DD2 was FTT, from what we were told it is lack of growth in any dimension for an extended time. We saw a pediatric GI and he was concerned about brain growth, he said that head circumference is not a valid way to measure brain growth. He said it is outdated and does not tell much. He did mention that she might eat more food if she didn't nurse but in our case, she wouldn't nurse very much either. She was big too, 22 lbs at 9 mths and still was 22 lbs at 17 mths. They said they don't care how big, they just want a progression. We did an endoscopy and it didn't show much. I would try and get referred to a ped GI, they are much more knowledgeable then just a pediatrician. We resorted to some practices that I am not very proud of, feeding high fat greek yogurt in front of the TV after dinner, following her around stuffing food in whenever I could. It worked tho and she gained and we now have no worries about her brain. Just wanted to share our experience...

February 3rd, 2012, 08:05 PM

@llli*lovemygirlso1

Re: failure to thrive, was told to wean

Wow your doc is silly. How on earth is cows milk better than breastmilk? I wouldn't wean if I were you and the PPs have great advice.

February 3rd, 2012, 08:17 PM

@llli*sarahak

Re: failure to thrive, was told to wean

I have no experience with FFT but I would not wean if that were the case. I am still nursing my 2 1/2 year old son and he nurses about 5 or 6 times a day. Most days he eats pretty well at meals but only usually 2 a day. He refuse to eat breakfast. "milky" is all he has until lunch and possibly a few bites of cereal. The doctor has never said aything about his weight. He is about 28 lbs and 35 inches tall. he is very active and my doctor knows that I only serve very healthy food so I don't get any complaints. I would let them know that you are continuing to nurse and that is the end of it. They need to help you and respect your decision.

February 4th, 2012, 10:23 AM

@llli*lovepickles

Re: failure to thrive, was told to wean

Thanks Ladies. We see the nutritionist on Monday. I'll stick to my "guns" ;)

I'm hoping it will go well.

<3

February 4th, 2012, 05:44 PM

@llli*zorkycharlemagne

Re: failure to thrive, was told to wean

Let us know how it went!

February 9th, 2012, 02:35 AM

@llli*lovepickles

Re: failure to thrive, was told to wean

Just a quick update ... our nutritionist gave us some great tips for getting DD to eat more. Really simple stuff regarding meal spacing and presentation. So far it is working and DD is happy. She suspects allergies because of her rashes but for now we are keeping a food journal and seeing how the month goes. Oh and she thought our pediatrician was totally off base by recommending weaning. She turned out to be a total ally and said not to drop any feedings as they weren't interfering with her meals.

Abaker89, we did get a referral to a joint allergy/GI pediatric dual visit for next month because of a suspicious rash and impossible to treat constipation. The nutritionist said the allergist wasn't so concerned with her length or head circumference but that her weight was the major concern. What did the endoscopy procedure entail? Were there other steps before the endoscopy or do they typically want to jump right in?

February 9th, 2012, 08:10 AM

@llli*scienceteachermommy

Re: failure to thrive, was told to wean

Isn't it wonderful when something that you think is going to be hard becomes really helpful!:clap It sounds like you got a good nutritionist.